Government scientific and medical advisers were questioned by MPs today about the science behind school closures and the government’s response to the Covid-19 pandemic.
The Parliamentary education committee held a hearing with government deputy chief medical officer Dr Jenny Harries, Department for Education chief scientific adviser Osama Rahman, his deputy Dr Dougal Hargreaves and Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, and professor of adolescent health at the UCL Institute of Child Health.
Here’s what we learned.
1. Daily contact testing presents ‘hypothetical risk of increasing transmission’
MPs asked the scientists to comment on the programme of mass testing in schools using rapid lateral flow tests, which give an answer within 30 minutes.
There have been concerns raised about the use of the tests after it was revealed they had not been approved by the Medicines and Healthcare products Regulatory Agency for use in keeping those who have been in close contact with Covid cases in the classroom.
Dr Hargreaves acknowledged the concerns about daily contact testing to improve attendance, and admitted there was “at least a hypothetical risk of increasing transmission”, and that the use of the tests in schools would be evaluated in the coming weeks.
“Where we are now is I think we need to be looking at a more detailed evaluation process, and we’ve got the time until half term to do that.”
Harries was also questioned about the accuracy of the tests, and said they were “accurate but with provisos”, adding that they helped to detect asymptomatic cases.
She claimed doing two lateral flow tests a week “is equivalent in effectiveness and accuracy” as one PCR test. This is because of the speed of response and the fact positive cases can “immediately” be taken out of circulation, she said.
She also said that the accuracy of the tests “has perhaps been misunderstood in some circles”.
“We’re finding it’s highly effective at probably around 80 to 85 per cent at picking up cases in their most infectious period where a PCR test will pick up viral fragments but over a much longer period”
Hargreaves said there was “broad consensus” that the tests could be used to pick up additional cases, but warned it was important not to “over-interpret” a negative test.
“If you get a negative test it doesn’t mean that you can ignore the usual mitigation procedures, you still need to be doing all of the social distancing, all of the hand washing, all of the mask wearing where appropriate.”
2. Vaccination of staff won’t help schools reopen
Scientists were also asked whether priotising vaccinations for education staff could mean schools open sooner.
Harries said vaccinating staff was “not the limiting factor to opening schools, it is community transmission rates”.
“They weren’t shut because there was a specific risk in that setting,” she added.
Harries insisted the decision on priority groups for the vaccine rested with the Joint Council for Vaccines and Immunisation, but said she “cannot see the link between vaccinating staff and a decision to open schools sooner or later”.
3. February reopening a ‘reasonable assumption’, but still some unknowns
The scientists were pressed on whether the government’s aim of reopening schools after February half term was likely to be met.
Harries said the date had been set by DfE “but it seems a perfectly reasonable assumption in the sense of if you’re looking at the epidemiology you’re watching a wave of virus come across the country”.
“We can see it’s hopefully starting to level off now in the original areas where the new variant rose, and we have a national lockdown and we can start to see that those numbers are starting to be contained,” she said.
“So you can get a sense of the timeframe in which those waves might come down and in which we could potentially open schools.
“What I can’t guarantee is that in this interval between now and February that there wouldn’t be another variant or we may find some other epidemiological change, so I think these are very sensible time estimates, but they need to be understood as not fixed dates.”
Harries added that she understood people wanted “very certain dates” for reopening, but “unfortunately that’s not how the virus works”.
4. Regional approach ‘likely’ after lockdown, but schools ‘top of priority list’
Asked if there could be a regional or phased system of reopening, Harries said it was “likely that we will have some sort of regional separation of interventions”.
“So I think on the broad epidemiology it is highly likely that when we come out of this national lockdown we will not have consistent patterns of infection in our communities across the county, and therefore as we had prior to the national lockdown it may well be possible that we need to have some differential application.”
However, she said that “clearly schools will be right at the top” of the priority list.
5. ‘Uncertainty’ over schools’ role in transmission
MPs were told there was still “uncertainty” about the role schools play in the transmission of the virus.
Viner said it was “important” to “separate out school-aged children from schools”, because “clearly children spend a lot of their time in schools but it is by no means all of their time”.
He said the role of school children themselves was now “more clear”, and although younger children play a “relatively minor role” in transmission “they do play a role, and it is foolish to think they do not”.
“Children do transmit this virus and they can bring it back from school to their households.”
He also he thought a “high level of social mixing, much of which also occurs outside of schools, is responsible for teenagers being more involved in transmission that we previously thought”.
“We don’t yet have a clear answer to whether how much of this transmission is within schools or it is actually fairly uncontrolled mixing outside of schools.”
Harries said that looking at evidence to date, it was “difficult” to “draw out” transmission in schools themselves and transmission “in school children when schools are open”.
“Overall what we should say is school children definitely can transmit infection in schools, they can transmit it in any environment, but it is not a significant driver as far as yet as far we can see of large-scale community infections, rather the other way around, that if there’s a rise in community rates then you’ll see a rise in children as well.”
6. ‘No evidenced increased risk’ to school staff
Harries was asked about calls from unions for school closures over concerns about risks to staff, and said government looked at a “number of sources” including local outbreak information assessed by Public Health England.
“I think the really important one for unions is around the ONS data and there is a very clear review and that’s done fairly routinely, that at the moment there is no evidenced increased risk to the teaching profession or educational staff in schools, and I think that is a really important one.”
7. Serious concerns about pupils’ mental health
Scientists today sounded warnings about the impact of the pandemic and partial school closures on pupils’ mental health.
Viner warned that he was aware of 75 international studies of “reasonable quality”, which told a “consistent” story of “considerable mental health harms”.
“When we closed schools, we closed their lives, not to benefit them, but to benefit the rest of society,” he told MPs.
He pointed in particular to the NHS’s study on the mental health of children and young people in England 2020, which found that the rate of serious mental health problems had increased from one in nine in 2017 to one in six in July.
“We can’t specifically say that change was due to the pandemic, because it could have been anything from 2017 to 2020, however, it’s very suggestive. They are collecting new data on the same group,” said Viner.
Viner said the message to parents had to be that the NHS was open, and called on the government to accelerate plans to improve mental health provision in schools.
8. System of controls ‘pretty effective’
Pressed on how schools would function when they reopen, Harries said schools “already have very good systems of controls”.
She said the fact the country hasn’t seen “vast numbers of schools with major outbreaks”, meant they could be “reasonably reassured” the system of controls was “pretty effective”
Harries said the way the virus is transmitted hasn’t changed, so measures DfE have recommended for schools previously “still apply”, but acknowledged the new variant is more transmissible and so interventions would be “monitored”.
Hargreaves said that last term “we had broadly a system that was working”.
“Schools were largely open and the R rate of transmission went down across most of the country.”
Asked about face coverings, he said they could be an “additional mitigation”, but said there were questions over whether the new variant would change that position “and I think we’ll know more about that in the next few weeks”.
9. Greenwich direction letter drafted before new strain statement
Rahman was asked about whether education secretary Gavin Williamson knew about the new strain of Covid-19 before he ordered Greenwich Council to withdraw its plea for schools to close early for Christmas.
It follows reports that the direction was issued over an hour after health secretary Matt Hancock spoke in Parliament about the new strain.
Rahman said the letter was written at “about 1.50pm” on December 14 (though he acknowledged it was sent later), and an announcement on the new strain was made in Parliament “a bit later in the day”.
He also revealed that ministers and policy officials normally receive summaries of key papers from SAGE meetings “within 48 hours”.